Analysis of perioperative complications and mortality in hospitalized elderly surgical patients
10.3760/cma.j.issn.0254-9026.2013.12.017
- VernacularTitle:住院老年手术患者围术期并发症与死亡情况分析
- Publication Type:Journal Article
- Keywords:
Intraoperative Period;
Cause of death
- From:
Chinese Journal of Geriatrics
2013;32(12):1319-1321
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the current situation of hospitalized elderly surgical patients and their perioperative mortality,in ordcr to develop possible strategies to reduce the mortality rate during the perioperative period in elderly patients.Methols A retrospective study of all hospitalized elderly patients (aged≥ 60 years) in our hospital from January 2006 to December 2010 was performed with statistical analysis focusing on the perioperative mortality-relative indexes (age,department,major morbidities and cause of death) in the hospitalized elderly surgical patients.Results Elderly patients accounted for 59.56％ of the total hospital admissions,while surgeries performed on elderly patients accounted for 49.95％ of the total number of surgeries,and elderly surgical patients accounted for 23.68％ of the admissions of elderly patients.The indications for surgery were mainly abdominal,urinary and orthopedic disorders.The perioperative mortality rate in hospitalized elderly surgical patients was 1.15 ％ (140/12140),which was higher than that in young and middle-aged patients of 0.26％ (34/12163) (P ＜ 0.001).There was no difference in the perioperative mortality between males and females (P＞0.05).The perioperative mortality rate in elderly patients was gradually increased along with aging (P ＜ 0.001).The perioperative mortality rates were relatively higher in neurosurgery and thoracic surgery than in other surgeries (all P＜ 0.001).Pulmonary infection,respiratory failure,multiple organ dysfunction syndrome (MODS),septic shock,heart failure and acute myocardial infarction were the main causes of perioperative death in elderly patients,with infection being the most important risk factor for death.However,primary disease progression was the leading cause of death during the perioperative period in young and middleaged surgical patients.Conclusions The surgical risks and perioperative mortality rate are higher in elderly patients.Adequate preoperative comprehensive assessment,careful consideration of operation necessity,surgical risk and benefit,optimum preoperative preparation,intraoperative and postoperative intensive care,timely discovery of abnormal conditions and efficient treatment are needed to reduce the surgical risk for elderly patients during the perioperative period.
